A study of safety and security practices on hospital wards caring for all acutely ill psychiatric patients in the State has found just 11 per cent of them have security desks at their entrance.
Furthermore, only 32 per cent of wards have an emergency telephone extension for staff; just 30 per cent have closed circuit television; only 16 per cent have a swipe card for those entering; and only 11 per cent a key pad with a security code.
Prof Seamus Cowman, professor of nursing and head of the School of Nursing at the Royal College of Surgeons in Ireland, who conducted the research, said the lack of security placed staff in a very vulnerable position.
He said violence and assaultive behaviour was a serious and growing problem in the health service generally and especially in the area of mental health services.
In the year 2000, assault was the second-biggest cause of injury to healthcare staff in the Republic, accounting for 19 per cent of all injuries.
He has recommended that service providers come together immediately to draw up guidelines for best practice on security on acute psychiatric wards.
Prof Cowman added that the guidelines would be of benefit to patients and staff and, in the long term, would cut down on insurance costs.
The general secretary of the Psychiatric Nurses Association, Des Kavanagh, said he was not surprised at the findings but was appalled nonetheless by the "continued neglect" by employers of security for staff on the front line.
He said there were 876 physical assaults on psychiatric nurses in 2002.
"The level of assault has increased over the last 10 years and we would have expected employers to have made a more reasonable response," he said.
Yet what was striking from the information Prof Cowman has gathered was the variation in security practices on acute psychiatric wards and the fact that there was no overall policy on best practice.
For example, 16 per cent of wards never banned disposable razors, 27 per cent never banned flexes or cables and 30 per cent never banned plastic bags. And in 17 per cent of wards, the main door was never locked. Smaller units were locked more often.
All 43 acute psychiatric wards, which include those in psychiatric and general hospitals, were surveyed by questionnaire.
The response rate was 86 per cent.
The number of beds on individual wards ranged between 13 and 50 and despite the fact that these wards cater for the sickest psychiatric patients, one-fifth had no access to intensive care units or seclusion rooms.
Prof Cowman said that while 92 per cent did have personal panic alarms for staff, infrastructure appeared to be lacking in support of safety and security.
"The lack of standardised security measures at the entrance to hospital wards requires further examination. The keypad system and swipe cards are in limited use across wards.
"The limited number of wards with a security desk and access to security guards may suggest that nurses and other mental health staff are expected to adopt more confrontational roles during episodes of violence," he said.
"The lack of such security measures places staff in a very vulnerable position," he added.